Popular among coprophiles, the game was first introduced to the downtown area of Pittsburgh in 2010 by Alex Pournaras, a Yugoslavian peasant who immigrated to Canada and later to the U.S., who claims to be its originator. Commonly known as The Butthole Guy or the shortened BHG for his regularly engaging in it, Alex would play the game with unsuspecting females by offering them a one hundred dollar bill (which he never had) if he couldn't accurately guess what they had for dinner every day during the previous week. This was achieved by his then bending them over and examining their rectal cavity with one of his fingers and smelling it. When necessary he would even lick off some of the smelly brown sewage to help determine its composition with his tastebuds. To give the impression that he had failed to accomplish his task he would often recite the following poem before submitting an answer:

Grilled cheese sandwich,
Tomato soup,
I smell a Twinkie,
The rest is poop.

By this means the thirty year old freshman of Point Park University with no clearly defined major or career goal was able to get multiple young girls to sleep with him.
Alex says, "Hey, Jarad, Rob, Danie', Vince—I tried to play The Butthole Game with this homeless girl recently and I caught herpes on my fingers. Does this mean I have to stop doing it?"

We reply sarcastically with one voice, "Nooooo, Alex, not at all."
by The Uptown Bandit November 5, 2014
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The object is to make the "okey-dokey" symbol with your hand (under the waist) and get another person to look at it. You can get lucky by just holding it sometimes, but sometimes you need to be clever about it.
If the other person looks you can punch them in the arm.
Prima: "Hey dude, I bruised my leg yesterday kicking this random person's ass, look."
(Prima makes sign on knee)
Segunda: "Really? Let me se- FFFUUU-"
(Prima proceeds to punch Segunda in the arm)

And THAT is the point of the butthole game.
by Dr.Anonymous December 24, 2009
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A variation of the "penis game" where players progressively yell the word butthole in public locations. The player to yell it the loudest without getting "caught" is declared the winner. A player can also be declared a winner with a "GAME-SET-MATCH"; this is when a player yells the word butthole at such a high caliber and level that it can not be defeated by any other player.
(on a school bus playing butthole game...)

will: butthole
nick: BUTTHOLE
will: BUTTHOLE!
nick: (screaming like a girl) BUUUUTTTTTTHHHHHOOOOOLLLLLLEEEEEE!!!!!
martin: game.... set.... match.....
by snare2 October 21, 2008
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